It is the holy grail of parenthood: a scientific consensus on the perfect bedtime routine for those young children who discover an irrepressible lust for life just at the moment when daylight wanes and duvets (should) beckon.
A Medical Research Council-funded study into the only roadmap that really matters to parents of children aged two to eight has identified six key goals and a scoring system that, when bedtimes descend once again into anarchy, flags the phases that parents are missing.
According to 59 UK experts including psychologists, dentists, public health specialists and other experts from education, health and sleep research, a scientifically defined “best practice” bedtime routine must include:
Brushing teeth before bed.
Time consistency for going to bed.
Book reading before bed.
Avoiding food/drinks before bed.
Avoiding use of electronic devices before bed.
Calming activities with the child before bed, including bath, shower and talking.
Parents need to achieve a score of over 50 points on the graded checklist, which tactfully takes parental stresses and difficulties into account as well as best practice and scientific advice.
“Bedtime routines are important family activities and have important implications on children’s wellbeing, development and health,” said Dr George Kitsaras, who led the study. “Organisations as diverse as the Book Trust to the BBC and the NHS are all engaged in this debate, but up to now there has been no real scientific consensus to inform them. We need to untie the conflicting signals and messages that parents receive.
“This lack of a clear consensus-based definition has limited health professionals’ ability to communicate best practice effectively with families,” he added. “This study provides that expert and scientific guidance for the first time.”
Children’s bedtimes can be one of the most stressful times of the day for parents. Recent US research found that children with inconsistent sleep schedules have higher body mass index (BMI) percentiles. And experts and sleep charities have said the coronavirus crisis is disrupting sleep patterns even further through heightening children’s anxiety and disturbing previously established routines.
Kitsaras’s study, Defining and Measuring Bedtime Routines in Families With Young Children, is published in Plos One, a leading scientific journal. It devised two different ways of scoring bedtime routines: one that measures a single routine, and the other collating activity over seven days.
“All activities around bedtime matter for children’s development and wellbeing,” Kitsaras said. “But from the wide range of activities around bedtime, our experts considered toothbrushing to be the most important to remember each night.
“There are strong links between inadequate oral hygiene practices and dental decay in children and adults. For children, early childhood caries can lead to higher occurrence of dental disease in later life, and in some cases untreated childhood caries can lead to extractions under general anaesthetic, causing additional problems for children and parents.
“Washing or having a shower each night before bed, on the other hand might be a common practice for families but our experts considered it to be part of a wider umbrella of child-parent interactions rather than a standalone practice we need to specifically target.”